Audit Rx / Claim Monitoring 

 

Gain clarity on your pharmacy benefit pricing and ensure competitiveness with Crystal Clear Rx’s Audit and Rx Claim Monitoring services. Uncover insights into your pricing structure and compare it with industry standards to optimize cost-efficiency.

Confirm Rx: Audit Rx Claim Monitoring

Critical Questions

Our Expert Audits Get Answers

Our expert audits address key questions such as:

Why is an audit necessary, and does my PBM have to adhere to their initial pricing agreements? We offer flexible audit options, whether single or multi-year, delving into financials to ensure contract guarantees are met and reviewing plan details for optimal management of copays and prior authorizations.

Additionally, our ongoing claims monitoring provides real-time insights, allowing you to take proactive measures and avoid unnecessary costs. Trust Crystal Clear Rx to empower you with actionable data, safeguarding your bottom line and maximizing the value of your pharmacy benefit.

ConfirmRX: The Ultimate PBM Audit Tool

Gain Control Over Your PBM Audits with Confirm Rx

In a complex and ever-changing pharmacy benefit landscape, transparency and accuracy are crucial. Confirm Rx, developed by Crystal Clear Rx, is designed to provide organizations with full visibility into PBM performance, ensuring compliance, identifying discrepancies, and maximizing cost recoveries. 

Why Choose Confirm Rx? 

    • Unbiased, Independent Auditing
      Unlike PBM-affiliated tools, Confirm Rx operates with complete independence, providing you with objective insights into your pharmacy benefits management. 
    • Seamless Integration & Flexibility
      Confirm Rx supports all types of pricing contracts, MAC lists, and plan designs, ensuring adaptability to your unique needs. 
    • Advanced Discrepancy Detection
      Our tool delivers detailed, actionable insights by identifying discrepancies in ingredient costs, dispensing fees, MAC pricing, drug exclusions, prior authorizations, and more. 
    • Executive-Level Reporting
      With our Audit Executive Summary, you get clear, comprehensive reporting, categorizing errors and facilitating productive discussions with PBMs and stakeholders. 

Comprehensive Features 

    • MAC Pricing – Generates a report showing claims with discrepant MAC pricings. 
    • Step Therapy & Quantity Limit Tracking – Ensure compliance with defined protocols and quantity limits. 
    • Specialty Drug Oversight – Isolate and assess specialty pricing to uncover savings opportunities. 

Want to Learn More?

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Free 20min Consultation

We’re Here To Help

Each of these concerns may be draining your resources. Crystal Clear Rx is proficient in the intricacies of the pharmacy benefit audit, and continually seeks avenues for cost savings and enhanced value for our clients. Trust us to safeguard your bottom line while optimizing your pharmacy benefit.

Phone

(800) 939-7290

Email

salesteam@crystalclearrx.com

Location

13809 Research Blvd. Suite 500 Austin, Tx 78750